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Opioid treatment audit forces N.H. to pay back $7.9 million in federal funds

A brick sign for the N.H. Department of Health and Human Services outside their Concord Campus.
Alli Fam
The report found New Hampshire lacked the resources to effectively enforce the state and federal standards for opioid treatment programs.

New Hampshire has agreed to repay nearly $8 million to the federal government after an audit found shortcomings in opioid treatment programs for the state's Medicaid patients.

The audit, conducted by the U.S. Department of Health and Human Services Office of Inspector General, found over 90% of the opioid treatment programs that cared for New Hampshire patients on Medicaid between July 2016 and July 2019 did not meet state and federal requirements.

The audit found the opioid treatment programs fell short on proper documentation, drug testing frequency and counseling hours.

“Providing fewer counseling services than are clinically necessary may negatively affect the outcome of a patient’s treatment,” auditors wrote.

The report also found New Hampshire lacked the resources to effectively enforce the state and federal opioid treatment standards. Only one person at the New Hampshire Department of Health and Human Services Bureau of Drug and Alcohol Services was responsible for overseeing the Medicaid providers delivering these services, according to the auditors.

The Medicaid providers responsible for administering the treatment programs also pointed to insufficient staff as one reason they failed to meet state and federal requirements.

In a letter responding to the audit, New Hampshire Medicaid Director Henry Lipman said he takes the findings seriously and is working to improve oversight. While Lipman acknowledged that the state fell short on ensuring programs were maintaining proper documentation, he said he did not believe this meant the programs were “being rendered by clinically unqualified personnel.”

Jake Leon, a spokesperson for the New Hampshire Department of Health and Human Services also noted the small sample size the federal auditors used to arrive at their findings. The auditors reviewed 100 randomly sampled claim lines of service from a total of nearly 1.5 million lines of service. Of the 100 services sampled, only 6 complied with federal and state requirements.

Colorado recently faced a similar federal audit and, like New Hampshire, had to pay back millions of dollars to the federal government.

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